Translating Adoption of Improved Varieties Into Nutritional Impact

NCT02710760 | Completed

• 1 other identifier: IRB14-3255
• Study Type: interventional
• Target: 978
• Locations: 0 countries
• Sites: N/A

Brief Summary

The purposes of this study are (1) to determine whether child nutrition-focused adoption encouragement messages focused on Quality Protein Maize (QPM) and the availability of small quantities of QPM seed can be effective at increasing QPM adoption and health outcomes for young children, and (2) to determine whether consumption encouragement messages and techniques (e.g., containers for earmarking) can be effective at increasing QPM targeting to and health outcomes for young children.

Conditions

Malnutrition

Keywords

Biomarkers; Child Nutrition Sciences; Economics, Behavioral

Outcome Measures

Primary Outcomes (33)

• Consumption of any QPM by the index child in the last 24 hours

  6-7 months

• Amount of QPM consumed by the index child in the last 24 hours

  6-7 months

• Index child's proportion of total maize consumption that was QPM in the last 24 hours

  6-7 months

• Consumption of any QPM by the index child in the last week

  6-7 months

• Number of days in the last week that the index child ate any QPM

  6-7 months

• Number of days in the last week that caregiver cooked a QPM-based food that was primarily for target children

  6-7 months

• Height-for-age Z-score of index child

  6-7 months

• Weight-for-height Z-score of index child

  6-7 months

• Weight-for-age Z-score of index child

  6-7 months

• Mid-upper arm circumference-for-age Z-score of index child

  6-7 months

• Insulin-like growth factor I (continuous measurement)

  6-7 months

• Amount of QPM reserved for home consumption

  6-7 months

• Hectares of QPM planted

  6-7 months

• Serum transthyretin

  6-7 months

• Consumption of any QPM by the index child in the last 24 hours

  10-11 months

• Amount of QPM consumed by the index child in the last 24 hours

  10-11 months

• Index child's proportion of total maize consumption that was QPM in the last 24 hours

  10-11 months

• Consumption of any QPM by the index child in the last week

  10-11 months

• Number of days in the last week that the index child ate any QPM

  10-11 months

• Number of days in the last week that caregiver cooked a QPM-based food that was primarily for target children

  10-11 months

• Height-for-age Z-score of index child

  10-11 months

• Weight-for-height Z-score of index child

  10-11 months

• Weight-for-age Z-score of index child

  10-11 months

• Mid-upper arm circumference-for-age Z-score of index child

  10-11 months

• Amount of QPM reserved for home consumption

  10-11 months

• Change in Height-for-age Z-score of index child

  6-7 months

• Change in Height-for-age Z-score of index child

  10-11 months

• Change in Weight-for-height Z-score of index child

  6-7 months

• Change in Weight-for-height Z-score of index child

  10-11 months

• Change in Mid-upper arm circumference-for-age Z-score of index child

  6-7 months

• Change in Mid-upper arm circumference-for-age Z-score of index child

  10-11 months

• Change in Weight-for-age Z-score of index child

  6-7 months

• Change in Weight-for-age Z-score of index child

  10-11 months

Secondary Outcomes (2)

• Serum lysine

  6-7 months

• Serum tryptophan

  6-7 months

Study Arms (3)

Control

NO INTERVENTION

Households in the control group receive no special treatment.

Adoption Encouragement Treatment

EXPERIMENTAL

Households in the Adoption Encouragement Treatment group were visited between March and April 2015 and offered "child nutrition focused" adoption encouragement. Both the male household head and the primary female caregiver were invited to attend these meetings (though the household head is the primary target), where the nutritional benefits of Quality Protein Maize (QPM) adoption for children were emphasized along with the agronomic properties. In addition, the fact that only small amounts of QPM are necessary to nourish children was highlighted and small seed bag sizes were offered. During the adoption encouragement visit, we offered the option to order up to three 2 kg bags of QPM for free.

Other: Adoption Encouragement Treatment

Consumption Encouragement Treatment

EXPERIMENTAL

In addition to receiving the Adoption Encouragement Treatment, households in the Consumption Encouragement Treatment group received additional information, targeted to the caregiver, and tools for separating Quality Protein Maize and targeting it to young children in the household in August 2015. They will additionally receive further guidance in February 2016.

Other: Adoption Encouragement Treatment; Other: Consumption Encouragement Treatment

Interventions

Adoption Encouragement Treatment OTHER

Households in the Adoption Encouragement Treatment received child nutrition focused guidance on the nutritional and agronomic benefits of Quality Protein Maize (QPM) adoption, and the opportunity to order up to 6 kg of QPM seed to plant in their own fields.

Adoption Encouragement Treatment; Consumption Encouragement Treatment

Consumption Encouragement Treatment OTHER

Households in the Consumption Encouragement Treatment received the same guidance as households in the Adoption Encouragement Treatment, as well as additional guidance on the importance of specifically targeting foods made with QPM to young children and tools to help households keep the grain separate and remember to feed QPM-based foods to the young children.

Consumption Encouragement Treatment

Eligibility Criteria

• Age: 6 Months - 35 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may not qualify if:

• Households in the study areas that do not have a member who attends a field day demonstrating Quality Protein Maize or who do not have a child in the appropriate age range are excluded from the study. Furthermore, households where the mother or children did not intend on staying in the region for the study duration (until the completion of the endline survey) were excluded from the study. Finally, we excluded participants who do not have access to land for crop cultivation.

Sponsors & Collaborators

• Harvard School of Public Health (HSPH): lead
• CIMMYT International Maize and Wheat Improvement Center: collaborator
• Ethiopian Public Health Institute: collaborator
• Agricultural Technology Adoption Initiative: collaborator

Related Publications (7)

• Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, Uauy R; Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013 Aug 3;382(9890):427-451. doi: 10.1016/S0140-6736(13)60937-X. Epub 2013 Jun 6.

  PMID: 23746772 BACKGROUND

• Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS; Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008 Jan 26;371(9609):340-57. doi: 10.1016/S0140-6736(07)61692-4.

  PMID: 18206223 BACKGROUND

• Ruel MT, Alderman H; Maternal and Child Nutrition Study Group. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013 Aug 10;382(9891):536-51. doi: 10.1016/S0140-6736(13)60843-0. Epub 2013 Jun 6.

  PMID: 23746780 BACKGROUND

• Masset E, Haddad L, Cornelius A, Isaza-Castro J. Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review. BMJ. 2012 Jan 17;344:d8222. doi: 10.1136/bmj.d8222.

  PMID: 22251864 BACKGROUND

• Girard AW, Self JL, McAuliffe C, Olude O. The effects of household food production strategies on the health and nutrition outcomes of women and young children: a systematic review. Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1:205-22. doi: 10.1111/j.1365-3016.2012.01282.x.

  PMID: 22742612 BACKGROUND

• Ghosh S, Suri D, Uauy R. Assessment of protein adequacy in developing countries: quality matters. Br J Nutr. 2012 Aug;108 Suppl 2:S77-87. doi: 10.1017/S0007114512002577.

  PMID: 23107551 BACKGROUND

• Donato K, McConnell M, Han D, Gunaratna NS, Tessema M, De Groote H, Cohen J. Behavioural insights to support increased consumption of quality protein maize by young children: a cluster randomised trial in Ethiopia. BMJ Glob Health. 2020 Dec;5(12):e002705. doi: 10.1136/bmjgh-2020-002705.

  PMID: 33355261 DERIVED

MeSH Terms

Conditions

Malnutrition; Behavior

Condition Hierarchy (Ancestors)

Nutrition Disorders; Nutritional and Metabolic Diseases

Study Officials

• Jessica Cohen, PhD

  Harvard Chan School of Public Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Global Health

Study Record Dates

• First Submitted: February 29, 2016
• First Posted: March 17, 2016
• Study Start: July 1, 2015
• Primary Completion: July 1, 2016
• Study Completion: July 1, 2016
• Last Updated: March 9, 2017

Record last verified: 2017-03

Data Sharing

• IPD Sharing: Will share